A Rare Case of M. marinum Isolated from CSF of Two Months Old Baby with Non-Communicating Hydrocephalus

Background- This case reports a one month old male child presenting with abnormal body movements of Genaralised Tonic Clonic Convulsion. CT scan revealed chronic sub-dural hematoma for which emergency craniotomy was done. Upon follow-up after 1 month of craniotomy, herniation from the bony gap was observed and CT scan and MRI revealed Non-communicating Hydrocephalus. So another operation was performed again placing VP shunt. The baby landed into septic shock like condition post operation. Objective- To identify an atypical mycobacteria from CSF sample isolated from a one month old baby having hydrocephalus. Method- Post VP Shunt CSF sample was sent for microbiological examination. ZN stain revealed acid fast bacilli. Culture on LJ media yielded smooth colonies after 7-10 days when incubated at 320C. Colonies were cream in colour and turned yellow when exposed to light (photochromogenic). Sample was sent to National JALMA Institute for Leprosy & Other Mycobacterial Diseases in Agra, Uttar Pradesh for speciation. Biochemical tests were conducted by standard methods described in the CDC manual. The results were interpreted as per the method of Kent and Kubica. Animal inoculation was done to check the pathogenicity of the strain. Result- On the basis of cultural characteristics and biochemical tests, the strain was identified as M.marinum. Conclusion- This case reports first instance of isolating Mycobacterium marinum in CSF of an infant with VP Shunt.

Author(s): R. Lalngaihzuali, Ostwal.K, Shaikh.N and Ingole.K

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